A former consultant surgeon has addressed the controversial issue around the ‘Golden Hour’ term, saying the term may no longer be recognised, but the principle it represents most definitely is.

Mr. Sam Ghareeb was part of a panel from the Save Our Acute Services (SOAS)  group who gave a presentation to Fermanagh and Omagh District Council recently about services at the South West Hospital (SWAH).

Members again raised the issue of the ‘Golden Hour’ (the concept that critically injured patients are required to receive definitive care within 60 minutes from the occurrence of injuries) which, according to a number of clinicians and the management of the Western Health and Social Care Trust, is now outdated.

This came as a shock to most members, but while it now appears the term ‘Golden Hour’ is outdated, the concept of urgent treatment within the first 60 minutes remains paramount.

Western Trust Medical Director Dr. Brendan Lavery told a previous meeting of the Council’s Health and Social Care Subcommittee the ‘Golden Hour’ concept was originally used “in the context of no organised trauma care, 1970’s-standard medicine, and no effective free hospital care, as was typical of that time”.

He continued: “It is reasonable to state this concept is outdated and is effectively a historical opinion that has become embedded in the public consciousness.

“Multiple studies carried out across the world have failed to find any significant survival advantage for trauma patients in shorter hospital pre-rescue times.

“Trauma care has changed beyond all recognition in the last decade, initially across England, Scotland and Wales, and within the last five years in Northern Ireland and the Republic of Ireland.”

However, councillors remain  sceptical, and they raised the issue at the most recent meeting.

Independent Councillor Josephine Deehan, who was actively involved in the campaign to save acute services in Tyrone County Hospital, said: “At that time the ‘Golden Hour’ was paramount.

“It was because so many Fermanagh patients would not be able access acute services in that hour we lost what we thought was a very good case.”

Councillor Donal O’Cofaigh, CCLA, agreed the Golden Hour concept was “decisive when it came to where the SWAH was to be located, so to hear it is suddenly out-of-date is ridiculous”.

He added: “It seems those in authority can just change the rules as they go along.”

Ulster Unionist Councillor Victor Warrington said: “We were told the ‘Golden Hour’ doesn’t exist; it’s a myth and it’s not there.

“To a degree, I disagree with that. We know how important it is with strokes and heart attacks.”

Sinn Fein’s Councillor Sheamus Greene claimed: “All of a sudden, the ‘Golden Hour’ doesn’t matter when it suits them [medical authorities].

“A few years ago, it was crucial. It seems extremely strange that medicine can change within a couple of years to suit the narrative at the time.”

In response, Mr. Ghareeb told members: “You are absolutely right. Where did it go? The ‘Golden Hour’ was talked about just a few years ago. This is a medical thing.

“They like to change the names, but it is same thing. I use the phrase ‘urgent cases’ which need to be dealt with immediately, whatever the name.”

Concluding the discussion, Councillor Paul Blake, SDLP, welcomed this clarification, as the ‘Golden Hour’ “is something the Western Trust used from the very beginning to dismiss our case”.

 

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